1. Field of the Invention
The present invention concerns a device for the reeducation of motor, or motor coordination, deficiencies in patients. It is more particularly, but not exclusively, applicable to reeducating people how to walk.
2. Description of the Prior Art
Generally, patients with neurological deficiencies following a central nervous system lesion (paraplegia and incomplete tetraplegia, hemiplegia of a vascular origin . . . ) lose, among other functions, the ability to walk.
Depending on the severity of the neurological lesion, a certain degree of motor and sensory recovery is possible and enables a certain recovery of the ability to walk, which, however, remains difficult in the majority of cases.
The objective of reeducation performed by a kinesiologist is to stimulate sensorimotor functions and body coordination with the goal of improving movement of the limbs and trunk.
After reeducation focused on isolated movements such as flexing and extension of the knee, the function in its entirety is reeducated, for example reeducation of how to walk.
The work of walking therefore begins after a certain time and is done with the feet on the ground and with permanent correction of movement provided verbally and physically. Different tools such as a walker, canes, parallel bars and splints can be used at different stages of progress.
For approximately ten years, a number of medical studies have demonstrated the interest of using a treadmill for reeducation of walking for these people. In the majority of these studies, the treadmill is used for walking exercise more intensively and repetitively than what is done in traditional reeducation. The presence of a therapist is useful in the beginning to help deficient limbs progress on the treadmill while correcting movement flaws. Walking on the treadmill is accompanied by some significant lightening of body weight, and this lightening is done by a traction system supporting the person using a harness worn on the trunk (thorax, abdomen and pelvis). By lightening the body weight, the patient's mass being constant, one understands that there is a decrease in the pressure corresponding to said mass on the treadmill.
One part of the traction system is located above the user; because of this, devices currently in existence are very bulky.
This system has advantages, in particular the possibility of practicing walking reeducation much earlier and more intensively (in terms of speed and endurance) than what is done with a traditional progression and technique. Indeed, the regular progress of the treadmill requires greater regularity of movement from the lower limbs during walking. The body weight may be lightened some in order to reduce, at first, difficulties related to balance.
The early nature of this system, which is immediately centered around walking, is clearly understood by the person, which increases his interest and motivation.
Walking reeducation is done without risk of falling, which reassures the patient, who can concentrate that much better on the quality of the motion.
Medical studies tend to show that this new method is more effective than traditional reeducation techniques in terms of recovering the quality of walking, meaning speed, ease, distance traveled. This effectiveness can be seen both in people who have been deficient for some time as well as those who have just suffered the neurological attack. The persistence over time of the positive effect after stopping this type of reeducation is unknown.
However, a number of drawbacks exist:
These systems are usually intended to be used by professionals and their costs are high, thus only hospital services can acquire them. Independent kinesiologists are not able to possess such devices, and private individuals even less so.
Moreover, long-term reeducation of people also raises problems. Patients who are unable to walk due to a problem of neurological origin manage to walk with some difficulty throughout their daily lives after reeducation and once they have returned to their homes.
Most often, patients walk to perform necessary trips and some, more motivated, walk more to perform actual exercise in order to better maintain, or even improve, their remaining ability to walk.
Likewise, to maintain these functions, doctors prescribe kinesitherapy sessions at home or in the office which, in practice, are sometimes too short and, after a certain time, limited in number by Social Security. Moreover, patients frequently spend part of the sessions performing exercises which are useful, but which often come at the expense of time devoted to work more specific to walking.
Overall, to make progress with walking or simply to maintain what has been acquired, it is necessary to walk more than is required by life at home (this is true both for ease and endurance). One notes that in practice, for many patients, this specific work is not intensive enough in terms of duration or intensity.
Clinical experience shows that most patients would be prepared to make more of an effort to improve their ability to walk, but that living conditions (lack of space to walk) and dependence on another person to go and walk outside (apprehension, risk of falling, climatic conditions, poor accessibility . . . ) often lead to confinement at home and very reduced amounts of walking.
In light of this observation, one may thus think that many people could benefit from walking training on a treadmill at home. This practice would make it possible to increase walking time by using a tool which is proving itself more and more in reeducation centers.
Practicing walking on a treadmill at home therefore has several potential advantages; however, in many cases, simple use of a treadmill by the patient alone is not feasible because there is no device making it possible to avoid falling, which can still occur on this type of device. Moreover, these treadmills do not integrate compact means for lightening the body and which are suitable for at-home use.
Indeed, a treadmill associated with body lightening means is a sizeable piece of equipment, in particular in terms of height, because the traction points and the rope attachments for the harness comprising said body lightening means are located above each shoulder; this device thus still comprises a sizeable portion located above the person's head. One part of the device is also located in front of or next to the body; this bulk is a disadvantage in the event the device is set up in a small space.
Such a device has the advantage of preventing any falls, but also the disadvantage of overly securing the user, who has no imbalance to compensate for. Walking, however, is largely based on an ability to compensate for a fall forward, in particular by moving one foot forward and balancing with the arms. Consequently, in this device, one important element of reeducation is not being exploited.